Literature DB >> 24944496

Subclinical abnormal glucose tolerance is a predictor of death in liver cirrhosis.

Diego García-Compeán1, Joel Omar Jáquez-Quintana1, Fernando Javier Lavalle-González1, José Alberto González-González1, Linda Elsa Muñoz-Espinosa1, Jesús Zacarías Villarreal-Pérez1, Héctor J Maldonado-Garza1.   

Abstract

AIM: To determine if subclinical abnormal glucose tolerance (SAGT) has influence on survival of non-diabetic patients with liver cirrhosis.
METHODS: In total, 100 patients with compensated liver cirrhosis and normal fasting plasma glucose were included. Fasting plasma insulin (FPI) levels were measured, and oral glucose tolerance test (OGTT) was performed. According to OGTT results two groups of patients were formed: those with normal glucose tolerance (NGT) and those with SAGT. Patients were followed every three months. The mean follow-up was 932 d (range of 180-1925). Survival was analyzed by the Kaplan-Meyer method, and predictive factors of death were analyzed using the Cox proportional hazard regression model.
RESULTS: Of the included patients, 30 showed NGT and 70 SAGT. Groups were significantly different only in age, INR, FPI and HOMA2-IR. Patients with SAGT showed lower 5-year cumulated survival than NGT patients (31.7% vs 71.6%, P = 0.02). Differences in survival were significant only after 3 years of follow-up. SAGT, Child-Pugh B, and high Child-Pugh and Model for End-Stage Liver Disease (MELD) scores were independent predictors of death. The causes of death in 90.3% of cases were due to complications related to liver disease.
CONCLUSION: SAGT was associated with lower survival. SAGT, Child-Pugh B, and high Child-Pugh and MELD scores were independent negative predictors of survival.

Entities:  

Keywords:  Diabetes mellitus; Glucose metabolism disorders; Liver cirrhosis; Oral glucose tolerance test; Survival

Mesh:

Substances:

Year:  2014        PMID: 24944496      PMCID: PMC4051945          DOI: 10.3748/wjg.v20.i22.7011

Source DB:  PubMed          Journal:  World J Gastroenterol        ISSN: 1007-9327            Impact factor:   5.742


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